Being Inspired to Do Better Every Time: A Conversation with Kirsty Bannister

Editor’s note: The 2025 North American Pain School took place June 22-27, 2025, in Montebello, QC, Canada, where four NAPSters also took part in the NAPS Science Communicators Program. This initiative helps the next generation of pain researchers and clinicians excel at communicating their own research and that of others to diverse audiences. As part of the program, participants interviewed visiting faculty and patient partners. Below is an interview with visiting faculty member Kirsty Bannister, conducted by Daniela Maria Escobar Espinal, one of this year’s Science Communicators.

Kirsty Bannister, PhD, is a professor in pain neuroscience in the Department of Life Sciences at Imperial College London, UK. The overarching aim of her research is to drive pre-clinical investigation of spinal and brain nociceptive circuits with the goal of better translating basic science research observations to the clinical domain.

In this interview, Dr. Bannister speaks with NAPS Science Communicator Daniela Maria Escobar Espinal, PhD, University of São Paulo, Brazil, to discuss her research, her experience as a woman in science, her advice for trainees, and much more. What follows is an edited transcript of their conversation.

Could you share with us how your journey in pharmacology began?

I didn’t completely know what degree I wanted to do, but I knew I wanted to move to London, where there are lots of really good universities. One of the really well-rated courses at University College London was pharmacology, and so I thought I’d apply for that, and I was lucky and got into it. I didn’t really know what pharmacology was until I started the course, but I quickly enjoyed it, and so by the end of the first year I was invested and felt like this was an area I would definitely like to stay in.

Your lab is known for integrating pre-clinical and clinical approaches to pain research. What is the biggest translation gap we must overcome to make pre-clinical pain models more relevant to the human pain experience?

We need to work harder to phenotype and stratify our patient cohorts and take the information we learn from those studies and back translate it to develop better animal models.

For example, when we aim to compare animal models of neuropathic pain with patients, it’s important to recognize that the neuropathic pain patient cohort is so varied in terms of what their phenotype is, and how they might be stratified according to, for example, gain of function or loss of function in small fiber neuropathy. That’s not reflected in our animal models, which are more of a one-size-fits-all. So, we need to take much more of our learnings from the clinical data, back translate, and generate and modify the animal models we use to better reflect that heterogeneity.

But we do also have to acknowledge that there is a gap between animal models and people, and we’re never going to be able to sufficiently fill it. It’s about, I suppose, reimagining the way we model disease in animals and how we can try and translate that data to a clinically meaningful outcome.

One of your main research areas involves descending pain modulation, a fascinating but complex system. Could you briefly explain how this pathway functions in animals and humans, and highlight key similarities or differences?

In both humans and animals, we have a system that occurs naturally to modulate spinal neuronal activity. These pathways can originate in higher midbrain and brainstem centers, and their projections can increase or decrease neuronal activity.

We’ve got a good handle on which specific brain regions are involved in originating those descending control pathways and we know that, cortically, a top-down influence on the output of descending controls can impact both nociception and pain. We see that with, for example, non-invasive brain stimulation in humans, but we can also apply genetic approaches in animal models that allow us to selectively manipulate those same brain regions involved in descending pain modulation.

So, we’ve got a really good handle on the translation of the output of those pathways but what’s less clear is what the circuits look like, in terms of the main areas of involvement, in humans versus animals. We know that the pathways exist in both species, and we know that they can inhibit or facilitate the transmission process of pain/nociception. But, for example, if we use fMRI to image the deep brainstem regions involved in descending modulation, such as the A5 nucleus and the A6 nucleus, that’s quite tricky because they’re such small loci, whereas in animals, we can control the output of those nuclei and have much better understanding of how they modulate neuronal activity. We do a lot of proxy measurements and have a lot of assumptions about which pathways we measure in animals are most likely to exist in humans.

From a pharmacological perspective, what makes the descending pain pathways especially relevant or promising targets for developing new pain therapies?

What is really interesting with the pharmacological targeting of these descending modulatory pathways is that drugs are already available to target them, including the tricyclic antidepressants, the SSRIs [serotonin-specific reuptake inhibitors], and the NRIs [norepinephrine reuptake inhibitors]. But we use them in a fashion that if we suspect there’s a dysfunction in the descending pain modulatory system, we’ll prescribe any one of them. But it is absolutely the case that some individuals will have a noradrenergic transmission dysfunction versus a serotonergic one. So, if you give someone a noradrenergic drug, such as an NRI, but actually their key issue is with a serotonergic modulatory pathway, you’re not going to see as big an effect. It comes back again to needing to better phenotype and stratify patients.

Switching gears, what strategies have you found most effective for communicating your role as a basic scientist working on translational research to patients and the broader community?

What is really reassuring for us as basic scientists is that the patient partners – the people with lived experience of pain – are really interested in pain research and they want to know more about it. So, the barriers that we may have felt were in place ten years ago actually aren’t there anymore. Because the minute we start to include those with lived experience, they really want to know about the preclinical studies and they give us input in terms of what research direction they think would be most interesting.

One of the ways to really get your message out to the broader community is to do outreach events. For example, lots of our studies have been in the national newspapers, and we’ve done lots of radio interviews to talk about our work and how it impacts the wider picture; for example, I’ve been on the radio to talk about the opioid crisis, and the use of antidepressants for pain. Those things allow an individual who isn’t a research scientist to start to understand how we’re working to improve our therapeutic approaches.

Those strategies are probably the most effective, but we also have initiatives like NAPS where patient partners attend and we have the opportunity to spend an entire week with them and ask them all sorts of questions. They’re so open and honest with their experience. And again, that helps us better communicate our science to them because we understand what they’re interested in and what they would like more explanation on or what they already understand. So it’s about immersing yourself with patients as much as you can and listening to what they have to say about their experience.

In recent years, you’ve received several prestigious awards, including the Patrick D. Wall prize from the International Association for the Study of Pain (IASP), and an award of the same name from the British Pain Society. What does this recognition mean to you?

I am incredibly humbled by both awards. The Patrick D. Wall award is, personally, the biggest professional highlight I think I’ll ever have. That’s because my dear friend and long-term mentor, the late Professor Stephen McMahon, nominated me for that award. He brought in Professor Frank Porreca and Professor Tony Dickenson and they all nominated me for the IASP award. And it was a huge honor to receive recognition from the British Pain Society as well. They’re a society that I work closely with; I’m on their scientific program committee, as I am for IASP.

Having that recognition from your community feels really reassuring and those awards would have had, I hope, a positive impact on their view of me as a researcher in pain neuroscience.

As someone actively involved with the IASP, your contributions go beyond the lab. What is the most powerful way young researchers can engage with the pain community and make meaningful contributions outside of the lab?

There are two main aspects that I’d encourage. IASP, for example, has an early-career network and it’s a wonderful way of getting to know people in the community and to contribute to different committees. So, for instance, we have a committee that is currently looking at our classification system of topics and we have early-career network members on that committee. We also have early-career network members on the scientific program committee for the IASP World Congress on Pain. So, it’s about volunteering yourself for these roles and being prepared to give up some of your free time to contribute.

The second thing I did that was so beneficial for me was applying to present a workshop at the European Pain Federation in 2017 with two really high-profile professors, Ralf Baron and Troels Jensen. They were really kind and they agreed to be part of that workshop with me. So, all of a sudden on my CV, I was able to say that I had run a successful workshop. This was my first workshop at a huge international conference and it was then easier for me to imagine doing that at IASP. I then went on to do workshops with Frank Porreca, Irene Tracey, and David Yarnitsky. You rely on the kindness of these people to come and do a workshop with you, but slowly but surely it helps you understand what a workshop looks like and how it can be successful.

You’ve mentored many students throughout your career. What is the best way to support and inspire the next generation of scientists?

It really depends on the mentee, because every single trainee is so different in terms of what their requirements are and how much direction they want. It’s about being flexible to the needs of the person in front of you and being patient; being a mum, I have learned a lot of patience. And it’s about being able to spot signs of when someone needs a bit more help, or, if an individual is flying with their freedom, you want to give them the space to continue and develop their research.

Have you ever felt that being a woman in science has influenced how your work is perceived or valued?

It is an unfortunate truth that there is still misogyny and sexism in academia. It’s becoming less prevalent, but it definitely still occurs. It’s so important to have a strong line manager who you respect and who respects you.

I’ve had instances where I feel that because I’m a woman, I’ve been treated differently. I’m sure that’s true for pretty much any female academic you would speak to. What I try to do is ensure that I don’t pass that behavior on, and also that I champion and cheerlead any of the women who I work with or who are my peers, to make sure that we all have as positive an experience as possible.

My PI was Tony Dickenson and he could not have been a kinder and more supportive individual, to me as a woman and as a mother. So, in many aspects, I’ve been very lucky in terms of the male line managers who’ve supported me as a woman in research.

As a mother and successful scientist, what advice would you give to young women navigating motherhood and a research career?

That’s really simple: Motherhood and family should always come first. It’s about trying to remember that family is the most important thing, and that sometimes things happen and you might find yourself expecting a baby when you haven’t planned it.

There’s never a perfect time – you’ll never feel secure enough in your career, even with a chair, even with a professorship, and you’ll never feel like you’re earning enough money, and if you’re living in a city, you’ll never feel like you’re living in a big-enough house. So, in some ways, if you’ve decided that having children is something you’d like to do, don’t put it off, because there’ll never be a perfect time; that’s life.

What keeps you inspired to continue your work in the lab and your engagement with students, patients and the wider community?

What inspires me is the passion I see in those around me doing the work. Whether they are clinicians or any kind of healthcare provider, patient partners, people with lived experience, or preclinical researchers who only do basic science, everyone is invested in a common goal: To help a population of individuals who are living with a chronic disease that is having a huge impact on their quality of life. That passion inspires me to keep going, to innovate, and to make sure my research is up to date and communicated effectively. They keep me wanting to do better every time.